Living abroad, I had, on average, about two steroid injections a year for 3/4 yrs (in the buttocks) whenever I was in a bad flare. Immediate relief for 4-8 weeks.
My now UK Rheumy simply said ‘we don’t do that here’
How often is it ok to have a steroid jab?
I know this is not what you want to hear…..but as infrequently as possible.Have you had a Dexa scan to test the density of your bones?
If you could get one done & the result was satisfactory…your doctor would tell you how frequently a steroid injection would be possible.
But if the scan showed any sign of osteoporosis…you would have to have a discussion.
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Steroid jabs are to be treated with caution and should not be used routinely to treat RA. I thought we had a rule no more than 3 in a year in exceptional circumstances. Are you on any RA medications which should be treating the RA ?
Thank you for the reply. I’m on Sulphazaline for my AS and just recently, I’ve been told I’m early RA so the new Rheumy is discussing Biologics with me. It’s all scary.
Honestly nothing to worry about or be scared by. x
My UK rheumy had a guideline of max three shots a year. My French rheumy will only give via an infusion once a year. (Apparently a risk of dimpling on the buttocks if yiu have a shot 😂 and she is French)
I had buttock dimpling (sounds like a strange country pursuit! 😂) with my first steroid injection but not with my second and the dimple has since disappeared.
Yes I had it too with a bruise. My GP fast tracked me to dermatology thinking it was a cancer!. It's gone now
I get that too…“we don’t do that here”, had it said to me more than once, my h as well. There are a few things that I've found differ & which I consider being a better option yet the UK Specialists & Doctors don't think is for whatever reason, often down to cost, yet I was previously under the equivalent of the NHS (SNS) so why it wasn’t down to cost but to the benefit of the patient there I’m unsure!
I think it has to be taken on a need only basis, & each of us has different needs. However, if steroids are necessary more regularly than is 'normal' it could indicate that meds aren’t working efficiently enough & a review should be performed. Just my thinking but I think it makes sense.
Anyway, I think for both general & targeted injections it's 3 or4 per year in the same place/joint due to potential damage to the area it's injected into (thinning of the skin) & possible cartilage damage with targeted injections. Then there's the issue of them affecting bone density, why we need DEXA scans when we have oral steroids, as well as injections, regularly. I think that's all, no doubt I’ll think of other reasons I’ve been given but that's all for now!
Regarding you & Garry having been abroad reminded me of my first 3 years with RA when I lived abroad - and my dosage of Methotrexate (MTX) (sorry this is deviating from steroid injections you were discussing!). My MTX was managed really well - the dose was optimised - unlike here in the UK (in my experience anyway). Abroad, the doctor kept a close eye on the inflammatory markers & how I was etc. & I was weaned down from I think it was 30mg to a maintenance dose of 10mg & then upped & downed incrementally when it merited it. I know it's not supposed to be changed up & down over short periods (it wasn't, it was gradual over months), but I feel it was the right thing to do, if monitored correctly, as it's toxic & one shouldn't be on more than is necessary for long periods in my view.
Back in the UK, when on MTX for another 13 years, I had to keep initiating the subject of reducing dosage as I was just left on 25mg doing well & forgotten about, when in fact, after getting the doc to reduce it gradually, I was still doing as well down on 10mg as a maintenance dose. Fair enough, if things had worsened on the way down, it should have been juggled a little to get the optimum. Much later on, my dear, fragile little mam developed RA very late in life & put on 25mg & no one was monitoring it either. After initial flares (I still think she was mis-diagnosed), she never had any RA symptoms again & no one even looked at reducing her dose, so I had to keep bringing it up with the doc in her appointments & gradually it was dropped right down to 10mg, still with no symptoms. It's wrong to mess around too much if things are working - and doses of drugs like MTX shouldn't be upped & downed willy-nilly, but it seems to be normal practice here in the UK (in my experience) sometimes to stick someone on a drug & if it works, to leave them on it, without attempting to optimise the dosage, therefore not optimising their health.
Maybe it's due to time constraints, but it doesn't seem entirely in the patients' best interests to leave them on higher doses of toxic drugs unnecessarily in some cases. My mam was vulnerable with complex health issues and being on more of a toxic drug than was necessary I'm sure made things worse for her not better. Also wastes resources. Not saying this always happens! but just from my own experience in comparison with when abroad!
Thanks for this reply. Interesting 🤔
Hi I have steroid injections to both hips and coccyx and get these done twice a year and I live in UK
Not sure if this was meant for me AC?
Oh, right. It's just I didn’t identify areas for injecting, buttocks specifically which were mentioned in the replies above mine, so it's confusing!
Sorry it was confusing……I’ve deleted my comment,I hope nobody is confused now.
Steroids should be used with caution but major side effects:
Thinning of the skin
Easy bruising
Weight gain
Puffiness of the face
Higher blood pressure
Cataract formation
Thinning of the bones (osteoporosis)
Rare but serious damage also can happen to the bones of the large joints (called “avascular necrosis”
Being honest that last one is a doozy means loss of mobility you always have to do risk/benefit with everything
I have just had a flare and a steroid Kenelog injection as was struggling, lat one I had was June 2021
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